Neuropathic Arthropathy

[bogdan_63]

Neuropathic joint disease (Charcot's joint) is a progressive destructive arthritis associated with loss of pain sensation, proprioception, or both. In addition, normal muscular reflexes that modulate joint movement are decreased. Without these protective mechanisms, joints are subjected to repeated trauma, resulting in progressive cartilage and bone damage. Neuropathic arthropathy was first described by Jean-Martin Charcot in 1868 in patients with tabes dorsalis. The term Charcot joint is commonly used interchangeably with neuropathic joint. Today, diabetes mellitus is the most frequent cause of neuropathic joint disease. A variety of other disorders are associated with neuropathic arthritis including leprosy, yaws, syringomyelia, meningomyelocele, congenital indifference to pain, peroneal muscular atrophy (Charcot-Marie-Tooth disease), and amyloidosis. An arthritis resembling neuropathic joint disease is seen in patients who have received frequent intraarticular glucocorticoid injections into a weight-bearing joint and in patients with CPPD. The distribution of joint involvement depends on the underlying neurologic disorder. In tabes dorsalis, knees, hips, and ankles are most commonly affected; in syringomyelia, the glenohumeral joint, elbow, and wrist; and in diabetes mellitus, the tarsal and tarsometatarsal joints.

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